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Calorie Regulation Prior to Alcohol Consumption Among Colle Running head: EXAMINING DRUNKOREXIA 2 An Examination of Drunkorexia: Calorie Regulation Prior to Alcohol Consumption among College Students Caroline Shriver Appalachian State University EXAMINING DRUNKOREXIA 3 Abstract Due to the high rates of underage drinking and disordered eating on college campuses, researchers have labeled the combination of these behaviors as "drunkorexia.” It describes excessive weight control methods prior, during, and after alcohol consumption. Various studies have explored the popularity of drunkorexia among college students, but few have investigated the relation of this behavior to organizations such as athletics or the Greek community. The purpose of this study was to determine whether a potential relationship exists between Greek affiliation, sex, class rank, alcohol consumption, eating patterns, and drunkorexia behaviors. This study also explored athletic affiliation and drunkorexia. All participants (n = 224) completed an online survey that included demographic questions, questions from the Eating Attitudes Test (EAT), College Life Alcohol Salience Scale (CLASS), and Drunkorexia Motives and Behaviors Scale (DMBS). Results indicated that higher levels of alcohol consumption were associated with Greek affiliation and higher levels of drunkorexia were associated with both Greek affiliation and athletic participation. Overall, there were weak gender and class differences for drunkorexia behaviors. The findings suggest that individuals who engage with the Greek or collegiate athletic community are more likely to consume excessive amounts of alcohol and exhibit drunkorexia behaviors. The results of the current study were generally consistent with previous literature that examined drunkorexia among college campuses. Noted are the implications for this study to tailor educational and intervention programs on eating and drinking behaviors for at-risk groups to reduce the prevalence of this harmful pattern on college campuses. EXAMINING DRUNKOREXIA 4 An Examination of Drunkorexia: Calorie Regulation Prior to Alcohol Consumption among College Students It is well-known that underage drinking is a common part of university culture. More specifically, the time period known as the “college years” (ages 18 to 24) is marked by extreme alcohol consumption (Substance Abuse and Mental Health Services Administration, 2004). Annually, alcohol use in 18 to 24 year olds plays a part in 97,000 sexual assaults, 1,800 deaths, 599,000 injuries, and 646,000 assaults (Hingson, Zha, & Weitzman, 2009). Excessive alcohol consumption is much higher in the 18 to 24-year-old age group, specifically those in college, when compared to 18 to 24 year olds not enrolled (White & Hingson, 2014). Results from a 2002 study by O’Malley and Johnston found that around 40% of college students have reported binge drinking in the previous 30 days, which is recognized as four or more drinks for females and five or more drinks for males in one occasion. The consequences that stem from high intakes of alcohol include sexual assault, unsafe sex, alcohol poisoning, harmful eating behaviors, and violent behavior (White & Hingson, 2014). Despite these negative consequences, students have expressed positive consequences of alcohol consumption, such as the ability to unwind, withdraw from the stresses of school, and a boost in social interactions (Park & Grant, 2005). Furthermore, the structure of a four-year university allows students to have more free time, easier access to alcohol, limited communication with parents, and diminished reinforcement of drinking laws (Weitzman, Nelson, & Wechsler, 2003). These factors contribute to the popularity of alcohol misuse with college students (Crawford & Novak, 2006). A fundamental aspect of the university culture is the endorsement of alcohol consumption and frequent heavy drinking. The increase in freedom and a social climate that embraces alcohol EXAMINING DRUNKOREXIA 5 prompts students to view alcohol as essential for an ideal college experience (Crawford & Novak, 2006). Excessive alcohol consumption is regarded as a “rite of passage” among students before they begin to take on more responsibility as an adult (Crawford & Novak, 2006). Those who do engage in heavy drinking believe alcohol will add to their college experience and consider it to be customary to the university culture (Crawford & Novak, 2006). Research has shown that in particular, first-year college students consume more alcohol and drink more regularly than older college peers (Weitzman, Nelson, & Wechsler, 2003). Freshmen are susceptible to encountering severe alcohol-associated problems during their first few months on a college campus (Larimer & Cronce, 2002). The stress from an increase in academic rigor, the acceptance of underage drinking as part of the university culture, and a lack of parental control all contribute to first-year students’ increase in alcohol consumption and frequency (Baer, 1994). Additionally, freshmen students comprise the majority of party-goers at social gatherings on campus and Greek houses where excessive alcohol consumption is common (Harford, Weschler, & Seibring, 2002). College students who consider alcohol to be vital to their college experience are prone to be heavy drinkers, have friends who engage in heavy drinking, and be in danger of suffering from alcohol-related issues (Crawford & Novak, 2006). Osberg et al. (2010) created The College Life Alcohol Salience Scale (CLASS), which assesses the degree to which students believe drinking is a necessary part of college life. Using that scale, Osberg and colleagues found that college students with the view that alcohol is essential to their time in college are likely to choose social settings that promote high levels of alcohol consumption (Osberg, Insana, Eggaert, & Billingsley, 2011). EXAMINING DRUNKOREXIA 6 The characteristics of participating in heavy drinking, a view that alcohol is crucial to college, and a setting that encourages drinking appear to be representative of social Greek organizations. Members of Greek organizations are more likely to regard alcohol as an essential part of the college experience than those who are not members and they choose the Greek community because of its affiliation with drinking (Ham & Hope, 2003). Previous research has suggested that those who are members of the Greek community are heavier and more frequent drinkers than those not affiliated (Routon & Walker, 2014). Fraternity and sorority members who engage in heavy alcohol consumption have a higher chance of suffering from the negative consequences of drinking, which include physical injuries, sexual assault, and driving under the influence (Ragsdale et al., 2012). Along with alcohol abuse being prevalent among college students, unhealthy eating behaviors are also common (Eisenberg, Nicklett, Roeder, & Kirz, 2011). Research has found a co-occurrence between alcohol consumption and harmful eating patterns (Bulik et al., 2004). College females are more vulnerable to body dissatisfaction and likely to develop unhealthy eating behaviors than college males (Grossbard, Lee, Neighbors, & Larimer, 2009). Moreover, roughly 60% of college females report taking up binge eating and habitual dieting (Tylka & Sulbich, 2002). College-aged males who engaged in heavy drinking displayed an increased desire for masculinity and self-esteem, which was subject to weight-related factors (Grossbard et al., 2009). First-year college students, specifically, were found in a study to be at a higher risk for developing harmful eating patterns (Hoffman, Policastro, Quick, & Lee, 2006). This is evidence that the “freshman 15,” which is a popular term describing weight gain during a student’s first year in college, is more than just a myth. EXAMINING DRUNKOREXIA 7 Due to the demands of both athletics and academics, student athletes often experience higher levels of stress than non-athletes (Kimball & Freysinger, 2003). A study found that student athletes who have greater levels of stress are more likely to engage in bad health habits (Hudd et al., 2000). Female college athletes exhibited more body dissatisfaction than female non-athletes and both male and female college athletes displayed more disordered eating habits than their respective counterparts (Pritchard, Milligan, Elgin, Rush & Shea, 2007). Furthermore, a comparison study of binge-drinking between student athletes and non-athletes found that athletes participated in more alcohol consumption and binge drinking than non-athletes (Tewksbury, Higgins, & Mustaine, 2008). It has been suggested that an increase in unhealthy drinking behaviors among college athletes may be due to the attitude of “work hard, play hard” that is popular in the athletic culture (Leichliter, Meilman, Presley, & Cashin, 1998). Recently, a study found that both females and males in college reported that they take part in extreme dieting and exercise to offset excessive amounts of alcohol consumption (Bryant, Darkes, & Rahal, 2012). This particular behavior has been labeled with the colloquial term “drunkorexia” by the media to characterize individuals who use extreme weight control methods such as starvation, binge eating, or purging to offset excessive alcohol use (Jennings, 2010). Drunkorexia can be represented through (a) neglecting meals to conserve calories or make up for the calories consumed through alcohol, (b) extreme weight loss methods to offset heavy drinking, and/or (c) drinking large amounts of alcohol to induce sickness that will lead to purging
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